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Insufficient Sleep
Insufficient Sleep in United States
United States

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Insufficient Sleep in depth:

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Insufficient Sleep by State

Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period

Insufficient Sleep Trends

Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period

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Insufficient Sleep

About Insufficient Sleep

US Value: 32.3%

Top State(s): Colorado: 26.8%

Bottom State(s): Hawaii: 39.4%

Definition: Percentage of adults who reported sleeping, on average, fewer than seven hours in a 24-hour period

Data Source and Years: CDC, Behavioral Risk Factor Surveillance System, 2020

Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation,, accessed 2023.

Insufficient sleep is a threat to public health. Sleep is critical to such basic functions as cognitive processing, mood regulation, blood sugar level and immune system response. Insufficient sleep is a risk factor for many chronic diseases, including cancer, depression, diabetes, hypertension and obesity.

Insufficient sleep is also associated with reduced productivity and quality of life, more poor mental and physical health days and increased risk of motor vehicle accidents, industrial accidents and medical errors. Drowsy driving caused 633 deaths in the United States in 2020, or 1.6% of all motor vehicle fatalities.

A 2016 report by the Rand Corporation estimated insufficient sleep cost $411 billion in missed work days and reduced productivity.

Research shows shift work schedules decrease sleep quality, which increases the risk of developing chronic sleep problems. Age, race and socioeconomic status are also strongly associated with insufficient sleep. 

The prevalence of insufficient sleep is higher among:

  • Men compared with women.
  • Adults ages 18-64 compared with those ages 65 and older, who have the lowest prevalence of insufficient sleep.
  • Hawaiian/Pacific Islander and Black adults compared with Asian, white and Hispanic adults.
  • Adults with lower levels of education compared with college graduates.
  • Adults with annual household incomes of less than $25,000 compared with those with incomes of $75,000 or more. 

The National Institute of Health recommends that adults sleep seven to eight hours nightly and school-aged children sleep between eight to 12 hours nightly. Everyone should follow a sleep schedule. It should be noted that making up for lost sleep through naps may provide short-term boosts of energy but does not provide the health benefits gained by regular adequate nighttime sleep.

Limiting use of electronic devices before bedtime may improve sleep quality — the blue light emitted from electronic devices can interfere with the body’s circadian rhythm. 

Policy solutions to address insufficient sleep in the U.S. are limited, though some industries have effectively minimized the hazards of insufficient sleep. For example, in 2011 the Accreditation Council for Graduate Medical Education limited the number of hours medical residents can work consecutively, which led to increased safety among employees and patients.

Healthy People 2030 objectives regarding sleep health include:

  • Increasing the proportion of adults who get enough sleep. 
  • Reducing the rate of motor vehicle crashes due to drowsy driving. 

Grandner, Michael A., Nicholas J. Jackson, Bilgay Izci-Balserak, Rebecca A. Gallagher, Renee Murray-Bachman, Natasha J. Williams, Nirav P. Patel, and Girardin Jean-Louis. 2015. “Social and Behavioral Determinants of Perceived Insufficient Sleep.” Frontiers in Neurology 6 (112): 1–14.

Jackson, Chandra L., Susan Redline, and Karen M. Emmons. 2015. “Sleep as a Potential Fundamental Contributor to Disparities in Cardiovascular Health.” Annual Review of Public Health 36 (March): 417–40.

Kecklund, Göran, and John Axelsson. 2016. “Health Consequences of Shift Work and Insufficient Sleep.” BMJ 355 (8080).

Liu, Yong, Anne G. Wheaton, Daniel P. Chapman, Timothy J. Cunningham, Hua Lu, and Janet B. Croft. 2016. “Prevalence of Healthy Sleep Duration among Adults — United States, 2014.” MMWR. Morbidity and Mortality Weekly Report 65 (6): 137–41.

Medic, Goran, Micheline Wille, and Michiel E. H. Hemels. 2017. “Short- and Long-Term Health Consequences of Sleep Disruption.” Nature and Science of Sleep 2017 (9): 151–61.

Stewart, Timothy. 2022. “Overview of Motor Vehicle Crashes in 2020.” NHTSA Technical Report DOT HS 813 266. Washington, D.C.: National Center for Statistics and Analysis, National Highway Traffic Safety Administration.

Weaver, Matthew D., Jason P. Sullivan, Céline Vetter, Wei Wang, Conor S. O’Brien, Salim Qadri, Christopher P. Landrigan, Charles A. Czeisler, and Laura K. Barger. 2017. “Work Hour Policies Are Associated With Improved Safety Among Medical Residents.” Sleep 40 (Abstract Supplement): A441.

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